• Utilization Management Nurse

    CVS Health (Atlanta, GA)
    …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required +...+ Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or… more
    CVS Health (07/18/25)
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  • Utilization Review Registered Nurse

    Emory Healthcare/Emory University (Atlanta, GA)
    …mentorship, _development,_ and leadership programs + And more **Description** The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be an expert in the utilization review… more
    Emory Healthcare/Emory University (07/19/25)
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  • Resource Utilization Nurse / RN

    Emory Healthcare/Emory University (Decatur, GA)
    …more! **Description** **8a-5:30p / Full Time / 36 hours** The **(RUN) Resource Utilization Nurse , LTAC** is primarily responsible for supporting the critical ... direct patient care assignment as needed while the primary nurse is off unit with another patient, and assisting...indvidual: + May assist the emergency department in the management of critical care patients awaiting inpatient bed admission… more
    Emory Healthcare/Emory University (06/27/25)
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  • Utilization Management

    Elevance Health (Columbus, GA)
    ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... accommodation is granted as required by law._ " The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
    Elevance Health (07/19/25)
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  • Utilization Management

    Elevance Health (Columbus, GA)
    ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... accommodation is granted as required by law._ " The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
    Elevance Health (07/15/25)
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  • Utilization Management

    Elevance Health (Columbus, GA)
    ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... integration, and ensures essential face-to-face onboarding and skill development. The ** Utilization Management Representative I** will be responsible for… more
    Elevance Health (07/19/25)
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  • Disease Management Nurse - Remote

    Sharecare (Atlanta, GA)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (07/12/25)
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  • Nurse

    Veterans Affairs, Veterans Health Administration (Atlanta, GA)
    …(inpatient and outpatient) 10+ years of managed care experience 10+ years of utilization management experience (utilizing Interqual & Milliman) 3.5 years of ... Summary This Registered Nurse position is available in Community Care. Responsibilities...for the coordination of education focused on staff education, self- management , and customer satisfaction throughout the healthcare continuum. Follows… more
    Veterans Affairs, Veterans Health Administration (07/13/25)
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  • Nurse (RN MGR/Head Nurse )

    Veterans Affairs, Veterans Health Administration (Atlanta, GA)
    …and Management experience preferred. 3 - 5 years of Utilization Management experience preferred. Physical Requirements: his position requires visual ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....and initiatives as well as customer service programs. The Nurse Nurse Manager (NM) is the designated… more
    Veterans Affairs, Veterans Health Administration (07/12/25)
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  • Case Manager, Registered Nurse

    CVS Health (Atlanta, GA)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Oncology or Specialty Pharmacy.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or … more
    CVS Health (07/18/25)
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